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P3.15.05 Determining obstetric risk factors and pregnancy outcome of fetuses with true knots of the umbilical cord
128 parthenogenesis information.
WEDNESDAY,
can be carried out only with maternal genetic
P3.15.05 DETERMINING OBSTETRIC RISK FACTORS AND PREGNANCY OUTCOME OF FETUSES WITH TRUE KNOTS OF THE UMBILICAL CORD E. Sheiner’ R. Hershkowitz’, T. Silberstein’, G. Holceberg’, I. Shoham-> Vard?, M. Katz’, M. Mazor’. Dept Ob/Gyn’ and Epidemiologyz, Soroka University Medical Center, Ben-Gurion University of the Negev, BeerSheva, Israel. Objective: To determine the obstetric risk factors and pregnancy outcome of fetuses with true knot of the umbilical cord. Study design: We analyzed 69139 singleton birth files. Deliveries occurred in the between the years 1990-1997. Fetuses with malformations were excluded. Results: The incidence of true knots was 1.2% (841169139). The following obstetric factors were found to be significantly correlated to true knots of the umbilical cord in a multiple logistic regression model: Chronic hypertension (OR=1.7; 95%CI 1.2.2.5), patients after amniocentesis (OR=1.2; 95%CI 1.1.IS), male fetuses (OR=1.5; 95%CI 1.3.1.7), prolapse of cord (OR=3.4; 95%CI 1.8-6.2) and cord around the neck (OR=1.9; 95%CI 1.6-2.3). The incidence of fetal distress and meconium stained amniotic fluid was significantly higher among patients with true knots of cord [7.0% vs 3.6%; 22.4% vs. 16.2 respectively, p
P3.15.06 EARLY ADAmATION AT NEWBORN HIGH INFECTIOUS RISK I. Antiuova, A. Aksenov, L. Kuzmenko, T. Tareeva, N. Bashakin, Moscow Regional Scientific Research Institute OBIGYN, Moscow, Russia Objective: The aim of the study was to investigate the features of early adaptation newborn high infectious risk for optimization of tactics conducting. Study Methods: We surveyed 156 newborn from the mothers with chronic infectious diseases (ChID) in the early neonatal period. Clinical, ultrasound and immunologycal methods were used. Results: It was established, that ChID of the mother renders serious adverse influence on a condition of a fetus and current of early adaptation at newborn, resulting to development hypoxic, infectious and toxic defeat of brain (49.6%), intrauterine hypotrophy (29.4%), intrauterine and postnatal infection (30.4%). Was established 4 variants of current early neonatal of the period depending on a condition of the child at birth and dynamics of a condition at the first hours o’clock. For newborn, high infectious risk (even clinically healthy) are characteristic to the infringements hemodynamics (later closing of fetal communications, decrease contractile activity of myocardium, high common peripheric vascular resistance, arterial hypertension), endocrine of adaptation (low level adrenocorticotrophin and cortisone), metabolism (decompensated metabolic and respiratory-metabolic acidosis, increase activity of blood enzyme), the change of the factors of specific and not specific protection (hypoimmunoglobulinaemia G is less 9.8 g/l, the decrease of a level scale gamma-interferon is less 8 ME, the increase of parameters activity peroxid oxidation of lipids - MDA is more 6 ngiml). Conclusion: Newborn from the mothers with ChID are the high risk children for disease in the early neonatal period. They need in the correction hemodynamics, metabolism and immunologycal disturbances.
SEPTEMBER
6
P3.15.07 EFFECTS OF INFERTILITY TREATMENTS ON THE NEONATAL HEALTH F. A. Beigi, Dept. OBIGYNIPED, Arash Maternity Hospital, Tehran University of Medical Sciences, Tehran, IRAN. Objectives: To evaluate health of newborns of women who conceived by infertility treatments. Study methods: In a prospective study on the 4,460 newborns that delivered at Arash hospital, Tehran university of medical sciences, from Feb 1996 to Jon 1999, the newborns of women who conceived spontaneously compare to those who used infertility treatments. Infertility treatment group divided into two group l-stimulation group 2assisted reproductive technology (ART) group. Results: Infertility treatments were reported for 6.3% of pregnancies (283 women, 314 newborns) relative risk of low birth weight, prematurity, intrauterine growth retardation, morbidity, transfer to neonatal intensive care unit and birth defects were approximately 3 times higher for the stimulation group and 4-6 times higher for the ART group. Conclusions: We found an association between infertility treatments and neonatal morbidity, and most of this impact appeared to be mediated by multiplicity and prematurity, therefore reducing the number of medically induced multiple pregnancies is the most effective prevent ion of neonatal morbidity related to infertility treatments.
P3.15.08 FETAL RENAL ANOMALIES AND FETAL ULTRASOUND G. Whincuu, Dept. PED, The Conquest Hospital, The Ridge, St Leonards on Sea, East Sussex, UK Objectives: To identify within the fetal population infants likely to have later true renal anomalies. Study Methods: A two year population sample (3,600 pregnancies) were included in a prospective study and had antenatal ultrasound scans on two or more occasions during pregnancy. Further scans were performed postnataly on infants where antenatal hydronephrosis was identified. Results: This study demonstrated an incidence of hydronephrosis of 10% with renal reflux of 1%. This is at odds with previously published figures. Within the study period infants who presented with a coincidental urinary tract infection but had normal scans antenatal were demonstrated reflux (20%). Conclusions: Antenatal ultrasound offers a safe and quick identification of the basic anatomy of the fetal kidney. It does not exclude reflux in this population. If neonatal scans at to and eight weeks with a full bladder are normal subsequent scans at nine months will also be normal. It is not possible to reassure the mother of a fetus that reflux does not exist hoewever antenataly.
P3.15.09 FREQUENCY AND STRUCTURE OF CONGENITAL MAJORMALFORMATIONS OF 10,000 NEWBORN INFANTS M. Josimovska, V. Mitevska, M. Mihajlovska, Medical Centre, Kumanovo, Republic of Macedonia. The importance of congenital malformations in practical neonatal pediatrics illustrates the data that about 1% of newborn infants during delivery have clearly showed major-malformations, i.e.. those which have significant medical, surgical and estetic consequences and which disturb organism functions and development, or some parts of the organism. Here, congenital malformations which are diagnosed later in childhood (heart, kidney, lung malformations), are not included. Newborn infants were observed at Newborn Infants’ Division at the GYN/OB Dept. in Kumanovo Hospital from 119 to November 1996, or in total, 10,000 newborn infants. In 1992 there were 1.1% malformations, in 1993 - 2%; in 1994 - 0.8%; in 1995 - 0.7% and in 1996 until November 4.9%. This shows that the frequency of congenital malformations is almost the same, and at 10,000 newborn infants that is 0.98%. In 1999 were 1880 newborn infants with 19 with who had malformations. According frequency in the first place are extremity malformations - 52% (pes equinovarus polidactilia, sundactilia); body malformations - 20% (evisceracia, rashishizis with or without meningomielocele); multiple congenital anomalies - 10% (syndrome Becwit, syndrome Down); then face malformations - 8%
WEDNESDAY,
can be carried out only with maternal genetic
P3.15.05 DETERMINING OBSTETRIC RISK FACTORS AND PREGNANCY OUTCOME OF FETUSES WITH TRUE KNOTS OF THE UMBILICAL CORD E. Sheiner’ R. Hershkowitz’, T. Silberstein’, G. Holceberg’, I. Shoham-> Vard?, M. Katz’, M. Mazor’. Dept Ob/Gyn’ and Epidemiologyz, Soroka University Medical Center, Ben-Gurion University of the Negev, BeerSheva, Israel. Objective: To determine the obstetric risk factors and pregnancy outcome of fetuses with true knot of the umbilical cord. Study design: We analyzed 69139 singleton birth files. Deliveries occurred in the between the years 1990-1997. Fetuses with malformations were excluded. Results: The incidence of true knots was 1.2% (841169139). The following obstetric factors were found to be significantly correlated to true knots of the umbilical cord in a multiple logistic regression model: Chronic hypertension (OR=1.7; 95%CI 1.2.2.5), patients after amniocentesis (OR=1.2; 95%CI 1.1.IS), male fetuses (OR=1.5; 95%CI 1.3.1.7), prolapse of cord (OR=3.4; 95%CI 1.8-6.2) and cord around the neck (OR=1.9; 95%CI 1.6-2.3). The incidence of fetal distress and meconium stained amniotic fluid was significantly higher among patients with true knots of cord [7.0% vs 3.6%; 22.4% vs. 16.2 respectively, p
P3.15.06 EARLY ADAmATION AT NEWBORN HIGH INFECTIOUS RISK I. Antiuova, A. Aksenov, L. Kuzmenko, T. Tareeva, N. Bashakin, Moscow Regional Scientific Research Institute OBIGYN, Moscow, Russia Objective: The aim of the study was to investigate the features of early adaptation newborn high infectious risk for optimization of tactics conducting. Study Methods: We surveyed 156 newborn from the mothers with chronic infectious diseases (ChID) in the early neonatal period. Clinical, ultrasound and immunologycal methods were used. Results: It was established, that ChID of the mother renders serious adverse influence on a condition of a fetus and current of early adaptation at newborn, resulting to development hypoxic, infectious and toxic defeat of brain (49.6%), intrauterine hypotrophy (29.4%), intrauterine and postnatal infection (30.4%). Was established 4 variants of current early neonatal of the period depending on a condition of the child at birth and dynamics of a condition at the first hours o’clock. For newborn, high infectious risk (even clinically healthy) are characteristic to the infringements hemodynamics (later closing of fetal communications, decrease contractile activity of myocardium, high common peripheric vascular resistance, arterial hypertension), endocrine of adaptation (low level adrenocorticotrophin and cortisone), metabolism (decompensated metabolic and respiratory-metabolic acidosis, increase activity of blood enzyme), the change of the factors of specific and not specific protection (hypoimmunoglobulinaemia G is less 9.8 g/l, the decrease of a level scale gamma-interferon is less 8 ME, the increase of parameters activity peroxid oxidation of lipids - MDA is more 6 ngiml). Conclusion: Newborn from the mothers with ChID are the high risk children for disease in the early neonatal period. They need in the correction hemodynamics, metabolism and immunologycal disturbances.
SEPTEMBER
6
P3.15.07 EFFECTS OF INFERTILITY TREATMENTS ON THE NEONATAL HEALTH F. A. Beigi, Dept. OBIGYNIPED, Arash Maternity Hospital, Tehran University of Medical Sciences, Tehran, IRAN. Objectives: To evaluate health of newborns of women who conceived by infertility treatments. Study methods: In a prospective study on the 4,460 newborns that delivered at Arash hospital, Tehran university of medical sciences, from Feb 1996 to Jon 1999, the newborns of women who conceived spontaneously compare to those who used infertility treatments. Infertility treatment group divided into two group l-stimulation group 2assisted reproductive technology (ART) group. Results: Infertility treatments were reported for 6.3% of pregnancies (283 women, 314 newborns) relative risk of low birth weight, prematurity, intrauterine growth retardation, morbidity, transfer to neonatal intensive care unit and birth defects were approximately 3 times higher for the stimulation group and 4-6 times higher for the ART group. Conclusions: We found an association between infertility treatments and neonatal morbidity, and most of this impact appeared to be mediated by multiplicity and prematurity, therefore reducing the number of medically induced multiple pregnancies is the most effective prevent ion of neonatal morbidity related to infertility treatments.
P3.15.08 FETAL RENAL ANOMALIES AND FETAL ULTRASOUND G. Whincuu, Dept. PED, The Conquest Hospital, The Ridge, St Leonards on Sea, East Sussex, UK Objectives: To identify within the fetal population infants likely to have later true renal anomalies. Study Methods: A two year population sample (3,600 pregnancies) were included in a prospective study and had antenatal ultrasound scans on two or more occasions during pregnancy. Further scans were performed postnataly on infants where antenatal hydronephrosis was identified. Results: This study demonstrated an incidence of hydronephrosis of 10% with renal reflux of 1%. This is at odds with previously published figures. Within the study period infants who presented with a coincidental urinary tract infection but had normal scans antenatal were demonstrated reflux (20%). Conclusions: Antenatal ultrasound offers a safe and quick identification of the basic anatomy of the fetal kidney. It does not exclude reflux in this population. If neonatal scans at to and eight weeks with a full bladder are normal subsequent scans at nine months will also be normal. It is not possible to reassure the mother of a fetus that reflux does not exist hoewever antenataly.
P3.15.09 FREQUENCY AND STRUCTURE OF CONGENITAL MAJORMALFORMATIONS OF 10,000 NEWBORN INFANTS M. Josimovska, V. Mitevska, M. Mihajlovska, Medical Centre, Kumanovo, Republic of Macedonia. The importance of congenital malformations in practical neonatal pediatrics illustrates the data that about 1% of newborn infants during delivery have clearly showed major-malformations, i.e.. those which have significant medical, surgical and estetic consequences and which disturb organism functions and development, or some parts of the organism. Here, congenital malformations which are diagnosed later in childhood (heart, kidney, lung malformations), are not included. Newborn infants were observed at Newborn Infants’ Division at the GYN/OB Dept. in Kumanovo Hospital from 119 to November 1996, or in total, 10,000 newborn infants. In 1992 there were 1.1% malformations, in 1993 - 2%; in 1994 - 0.8%; in 1995 - 0.7% and in 1996 until November 4.9%. This shows that the frequency of congenital malformations is almost the same, and at 10,000 newborn infants that is 0.98%. In 1999 were 1880 newborn infants with 19 with who had malformations. According frequency in the first place are extremity malformations - 52% (pes equinovarus polidactilia, sundactilia); body malformations - 20% (evisceracia, rashishizis with or without meningomielocele); multiple congenital anomalies - 10% (syndrome Becwit, syndrome Down); then face malformations - 8%